| NPI | 1104011972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1231319) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 2007027445) |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2026-07-15 |